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05-2014 (RPL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: �05-00002014- N Property Address: I- - - APN: 44676 LIBERTY AVE Application description: 604-512-013-51 -24197 - Property Zoning: POOL - RESIDENTIAL Application valuation: LOW DENSIT Applicant: ° D MAY 26 2005 Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT --------_����,��------------------ AINAt-C%IC R'S DECLARATION I hereby affirm uFesPgSijLi'yr1t at�l aro licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or .that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). 1 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason Date: �LO — �� Owner: CONSTRUCTION LEN000 AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/26/05 Owner: --------------------------------- CULLEN, MIKE Contractor: --------------------------------- Owner' ----------------------------------------------- WORKER'S COMPENSATION DECLARATION _ I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier - - - - - - - - - - - - - - - - - - - - - -- Policy Number _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize presents Ives of this county too enter u on the above-mentioned prop ett 'rispection purpoVes. D ��� `5i nature (Applicant or Agentl: LQPERMIT Application Number" . . . . . 05-00002014 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . 135.00 Plan Check Fee 87.75 Issue'Date . . . . Valuation 12000 Expiration Date 11/22/05 Qty Unit Charge Per Extension BASE FEE 45.00 10.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 90.00 Permit . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 11/22/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ---------------------------------------------------------------------------- EA MECH FURNACE >100K 11.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan -Check Fee 11.25 Issue Date Valuation 0 Expiration Date 11/22/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . Valuation 0 Expiration Date 11/22/05 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL.& SPA ONLY. ALARMS/BARRIERS SHALL LQPERMIT LQPERMIT Application Number . . . . . 05-00002014 -' ------------------------------------------------------------------------------ Special Notes and Comments BE IN PLACE PRIOR TO PRE -PLASTER INSPECTION. EQUIPMENT ENCLOSURE NOT INCLUDED IN PERMIT. Fee summary ----------------- Charged Paid -------------------- Credited -------------------- Due Permit Fee Total 239.00 .00 .00 239.00 Plan Check Total 113.75 .00 .00 113.75 Grand Total 352.75 .00 .00 352.75 LQPERMIT CITY OF LA QUINTA SUB -CONTRACTOR LIST ` JJB ADDRESS 4_4 & 7(p L 16587-K 4 L - 0 - PERMIT NUMBER OWNER OL)L-LE41 BUILDER This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade /Classification Contractor Is State:Contractor's License Workers Compensation Insurance City Business License Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) : V a? 31 ' i — 3—lfo'b(o CONCRETE (C=8) Z S� l G - _ 1 ��'� p �S I c/ (1-,30' FRAMING (C-5) STRUCT: STEEL (C-51) MASONRY (C-29) PLUMBING (C 36) C.3(0 C53 ,S0CUq/ S � M / - OCO 12 - 3 05% QQ " LATH, PLASTER (C-35) LTCRI �tS C53 —710&96— '31-0. L / G 9 DoP" CQ9-0%1 JL - DRYWALL (C-9) HVAC (C-20)' ELECTRICAL (C-10) L L -FS f� [� C 9� _ 0 -DS l` jJ/�% // �7 ��D((� a- /r� 0 � 'U ROOFING (C-39) SHEET METAL (C-43) FLOORING '(C 15) :GLAZING (017Y:..: INSULATION (C-2):. SEWAGEDISP. (C -42V:.,-.. PAINTING (C733) CERAMIC TILE (C.-54) c," • CABINETS (C-.6).': FENCING (C-13) LANDSCAPING (0=271 :: © VI POOL IC -531> ; Bin 'CitY of LaQuinta Building 8i'. Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # S- Zoe Project Address: A. P. Number: _ L __01 Owner's Name: ` Address: 1-4 O len Legal Description: Contractor: City, ST, Zip: P Tele hon �^7 JJ Address: Project Description: ...................:::::::::::::::::.::::::::. City, ST, Zip: / L Telephone: ePh0ne: 0 i 1 b 1 State Lic. # : City Lic. #: """/x / 5')( Arch., Engr., Designer: 523A,5 Address: City, ST, Zip: Telephone: e. Con o StrUC I t nT Y an Type: Occupancy: P cY. State to Li Po ect type (circle one): . N v Add'n Alter Repair r De mo Name of Contact Person: I I Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: — 4 Estimated Value of Project: . APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item `A Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees ETotalPermit Fees --n '7" tpd?¢` ' z�} r.T. r fTj BULf INCA & SAFETY [SEPT. APPROVED FOR CONSTRUCTION DAA 5123 IOS BY %M t W